
Aetna Medicare Advantra Central Value (PPO), Aetna Medicare Advantra Credit Value (PPO),
Aetna Medicare Advantra Preferred Plan (PPO), Aetna Medicare Advantra Silver (PPO), Aetna
Medicare Advantra Value (PPO), Aetna Medicare Choice II Plan (PPO), Aetna Medicare Choice
Plan (PPO), Aetna Medicare Credit Plan (PPO), Aetna Medicare Discover Value Plan (PPO),
Aetna Medicare DMG Prime (PPO), Aetna Medicare Elite (PPO), Aetna Medicare Elite Plan
(PPO), Aetna Medicare Elite Plan 2 (PPO), Aetna Medicare Elite Plan 3 (PPO), Aetna Medicare
Essential Elite Plan (PPO), Aetna Medicare Essential Plan (PPO), Aetna Medicare Explorer Elite
(PPO), Aetna Medicare Explorer Plan (PPO), Aetna Medicare Explorer Premier (PPO), Aetna
Medicare Explorer Premier 2 (PPO), Aetna Medicare Explorer Premier Plan (PPO), Aetna
Medicare Explorer Premier Plus (PPO), Aetna Medicare Explorer Value (PPO), Aetna Medicare
Freedom Core Plan (PPO), Aetna Medicare Freedom Plan (PPO), Aetna Medicare Freedom
Preferred Plan (PPO), Aetna Medicare Gold Plan (PPO), Aetna Medicare Platinum Plan (PPO),
Aetna Medicare Plus Plan (PPO), Aetna Medicare Preferred Premium Plan (PPO), Aetna
Medicare Premier (PPO), Aetna Medicare Premier (Regional PPO), Aetna Medicare Premier 1
(PPO), Aetna Medicare Premier 2 (PPO), Aetna Medicare Premier Plan (PPO), Aetna Medicare
Premier Plus (PPO), Aetna Medicare Premier Plus 2 (PPO), Aetna Medicare Premier Plus 2
(Regional PPO), Aetna Medicare Premier Plus Plan (PPO), Aetna Medicare Prime (PPO), Aetna
Medicare Prime 1 (PPO), Aetna Medicare Prime Credit (PPO), Aetna Medicare Prime Premier
(PPO), Aetna Medicare Select Plan (PPO), Aetna Medicare SNJ Prime Elite (PPO), Aetna
Medicare The Valley Plan (PPO), Aetna Medicare Value (PPO), Aetna Medicare Value Plan
(PPO), Aetna Medicare Value Plus Plan (PPO)
Last Updated: 04/01/2022
ABIRATERONE
NR_0009_3741 09/2014
Formulary ID: 22007: version 12 1